Treatment approaches to postoperative fibrinoid syndrome after phacoemulsification

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Abstract

BACKGROUND: Postoperative fibrinoid syndrome (PFS) is an early complication of phacoemulsification, manifested by fibrin deposition on the iris and the intraocular lens surface, which leads to visual acuity decrease.

AIM: To assess the rate and the treatment efficacy (by YAG laser, enzymatic, medicalmentous) in PFS after phacoemulsification.

MATERIALS AND METHODS: Retrospective analysis of 56,019 cataract surgery cases of 2017–2021. There were 49 patients with PFS divided into 3 groups according to treatment approaches: 1st group — medicamentous treatment (MT) + YAG laser destruction of the fibrin film (n = 6); 2nd — MT + prourokinase injection into the anterior chamber (n = 6); 3rd — MT only (n = 37).

RESULTS: There was no difference between groups in best-corrected visual acuity (BCVA) before the PFS development. There was a more rapid increase in BCVA in the 1st and the 2nd groups compared with the 3rd one on the third day (0.20 ± 0.09 and 0.21 ± 0.08 versus 0.09 ± 0.08 for groups respectively, p = 0.001) and on the fifth day of treatment (0.25 ± 0.10 and 0.27 ± 0.13 versus 0.16 ± 0.14, p = 0.029). Nevertheless, in one week, there was no difference in BCVA between groups. Unfortunately, BCVA did not return to baseline in any group.

CONCLUSION: The incidence of PFS after phacoemulsification is relatively low and amounts to 0.093%. The most rapid BCVA recovery was observed in the 1st and the 2nd groups.

About the authors

Dmitrii F. Belov

Saint Petersburg Multifield Hospital No. 2

Author for correspondence.
Email: belovd1990@gmail.com
ORCID iD: 0000-0003-0776-4065
SPIN-code: 2380-2273

MD, Cand. Sci. (Med.), Ophthalmologist

Russian Federation, Saint Petersburg

Vladimir P. Petukhov

Saint Petersburg Multifield Hospital No. 2

Email: v.p.petukhov@gmail.com
ORCID iD: 0000-0003-4973-3937
SPIN-code: 2879-9313

Ophthalmologist

Russian Federation, Saint Petersburg

References

  1. Gndoyan IA. Use of the fibrinolytic drug trombovazim in the fibrinoid syndrome treatment after cataract extraction. Journal of Volgograd State Medical University. 2012;(2):28–32. (In Russ.)
  2. Boiko EhV, Danilichev VF, Kol’tsova SV. Ehksperimental’noe obosnovanie primeneniya rekombinantnoi prourokinazy i ee immobilizirovannykh form dlya lecheniya posleoperatsionnogo fibrinoidnogo sindroma v oftal’mologii. Byulleten’ eksperimental’noj biologii i mediciny. 1997;123(2):201–204. (In Russ.)
  3. Novoderezhkin VV. Lazernaya korrektsiya fibrinoidnogo sindroma v posleoperatsionnom periode posle ehkstraktsii katarakty. Russian Journal of Clinical Ophthalmology. 2001;(3):114. (In Russ.)
  4. Nishi O. Fibrinous membrane formation on the posterior chamber lens during the early postoperative period. J Cataract Refract Surg. 1988;14(1):73–77. doi: 10.1016/s0886-3350(88)80068-3
  5. Ficker L, Meredith TA, Wilson LA, et al. Chronic bacterial endophthalmitis. Am J Ophthalmol. 1987;103(6):745–748. doi: 10.1016/s0002-9394(14)74386-7
  6. Logai IM, Leus NF. Selektivnye ingibitory sinteza prostaglandinov. Oftal’mologicheskii zhurnal. 1999;(4):286–293. (In Russ.)
  7. Müller-Jensen K, Rörig M, Hagele J, Zimmermann H. Effect of cataract technique and duration of surgery on fibrin reaction after IOL implantation. Ophthalmologe. 1997;94(1):38–40. doi: 10.1007/s003470050081
  8. Boiko EhV, Danilichev VF, Sazhin TG. Ehnzimoterapiya fibrinoidnogo sindroma. Fyodorov Journal of Ophthalmic Surgery. 2005;(3):25–29. (In Russ.)
  9. Apple DJ, Solomon KD, Tetz MR, et al. Posterior capsule opacification. Surv Ophthalmol. 1992;37(2):73–116. doi: 10.1016/0039-6257(92)90073-3
  10. Singh S, Pardhan S, Kulothungan V, et al. The prevalence and risk factors for cataract in rural and urban India. Indian J Ophthalmol. 2019;67(4):477–483. doi: 10.4103/ijo.IJO_1127_17
  11. Avetisov KS. Acoustic density of cataracts. The Russian annals of ophthalmology. 2015;131(2):38–44. (In Russ.) doi: 10.17116/oftalma2015131238-44
  12. Potyomkin VV, Ageeva EV. Zonular instability in patients with pseudoexfoliative syndrome: the analysis of 1000 consecutive phacoemulsifications. Ophthalmology Journal. 2018;11(1):41–46. (In Russ.) doi: 10.17816/OV11141-46
  13. Potyomkin VV, Goltsman EV. Cataract surgery in pseudoexfoliation syndrome. Ophthalmology Journal. 2020;13(1):37–42. (In Russ.) doi: 10.17816/OV25739
  14. Dedov II, Shestakova MV, Galstyan GR. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes mellitus. 2016;19(2):104–112. (In Russ.) doi: 10.14341/DM2004116-17
  15. Sheng Y, Sun W, Gu Y, et al. Endophthalmitis after cataract surgery in China, 1995–2009. J Cataract Refract Surg. 2011;37(9): 1715–1722. doi: 10.1016/j.jcrs.2011.06.019
  16. Oswal KS, Sivaraj RR, Murray PI, Stavrou P. Clinical course and visual outcome in patients with diabetes mellitus and uveitis. BMC Res Notes. 2013;29(6):167. doi: 10.1186/1756-0500-6-167
  17. Christopher KL, Hood CT, Mian SI, et al. Endophthalmitis in advanced microbial keratitis: risk factors and examination findings. Cornea. 2020;39(9):1096–1101. doi: 10.1097/ICO.0000000000002349
  18. Norris JW, Chirls IA, Santry JG, et al. Severe fibrinous reaction after cataract and intraocular lens implantation surgery requiring neodymium: YAG laser therapy. J Cataract Refract Surg. 1990;16(5):637–639. doi: 10.1016/s0886-3350(13)80784-5
  19. Boiko EV, Danilichev VF, Sazhin TG, et al. Comparison of the pharmacokinetics of recombinant prourokinase in non-invasive methods of administration (drops, electrophoresis, therapeutic contact lenses). Russian journal of clinical ophthalmology. 2017;18(4):213–218. (In Russ.) doi: 10.21689/2311-7729-2017-17-4-213-218
  20. Suvorov AS, Sazhin TG. Enzymotherapy of toxic anterior segment syndrome after phacoemulsification. Ophthalmology Journal. 2017;10(2):87–93. (In Russ.) doi: 10.17816/OV10287-9
  21. Osaadon P, Osaadon P, Lavy I, et al. Intracameral r-tPA for the management of severe fibrinous reactions in TASS after cataract surgery. Eur J Ophthalmol. 2022;32(1):200–204. doi: 10.1177/11206721211002064
  22. Wedrich A, Menapace R, Mühlbauer-Ries E. The use of recombinant tissue plasminogen activator for intracameral fibrinolysis following cataract surgery. Int Ophthalmol. 1994;18(5):277–280. doi: 10.1007/BF00917830
  23. Heiligenhaus A, Steinmetz B, Lapuente R, et al. Recombinant tissue plasminogen activator in cases with fibrin formation after cataract surgery: a prospective randomised multicentre study. Br J Ophthalmol. 1998;82(7):810–815. doi: 10.1136/bjo.82.7.810
  24. Ben Simon GJ, Kenet G, Spierer A. Fibrinoid reaction after lens extraction in rabbit eyes. J Cataract Refract Surg. 2012;38(5): 890–893. doi: 10.1016/j.jcrs.2011.12.026

Supplementary files

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2. Fig. 1. Postoperative fibrinoid syndrome manifestations: fibrin depositions on the intraocular lens and iris surface spreading into the iridocorneal angle

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3. Fig. 2. Preserved red reflex from the funduspresence in the setting of fibrin exsudation ion

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4. Fig. 3. Irregular pupil as an outcome of postoperative fibrinoid syndrome

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5. Fig. 4. Best-corrected visual acuity dynamics due to treatment regimen

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Copyright (c) 2022 Belov D.F., Petukhov V.P.

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